Pain during cement injection in percutaneous vertebroplasty under local anesthesia
Objective To investigate the causes of pain during cement injection in percutaneous vertebroplasty under local an-esthesia.Methods One hundred and four cases of osteoporotic vertebral compression fractures treated with percutaneous ver-tebroplasty from October 2021 to October 2022,with lower back pain during intraoperative injection of bone cement were retro-spectively analyzed.According to the VAS score of pain during intraoperative injection of bone cement and whether painkillers were used,patients were divided into three groups:group A(18 cases)had a VAS score of ≥7 for intraoperative pain,and pa-tients who were unable to maintain a supine position due to lower back pain during surgery received intravenous painkillers;group B(46 cases)had a VAS score for intraoperative pain ranging from 4 to 7 points and the surgery was completed after a brief rest due to pain,and no medication intervention was given;group C(40 cases)had a VAS score of ≤4 for intraoperative pain,but it was tolerable and did not affect the surgical procedure.The bone density,vertebral compression degree,onset time,amount of bone cement injection,and pain VAS score among three groups were compared.Results There was a statistically significant difference(P＜0.05)among the three groups in terms of bone density,vertebral compression degree,onset time,and VAS score for preoperative and postoperative immediate pain;There was no statistically significant difference(P＞0.05)in the amount of bone cement injection and VAS score of pain one week after operation.Conclusion For patients with mild osteoporosis,long onset time,severe vertebral compression,and poor preoperative pain tolerance,percutaneous vertebroplasty with bone cement in-jection under local anesthesia may be more prone to lower back pain.Although intraoperative pain does not affect postoperative efficacy,in order to prevent adverse medical experiences caused by intraoperative pain for patients,preoperative evaluation and prevention should be carried out based on relevant influencing factors.
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